HENTIES BAY
TOURISM ASSOCIATION
POSTAL ADDRESS: P.O. BOX
595, HENTIES BAY
APPLICATION FOR MEMBERSHIP FOR THE PERIOD 1 MARCH 2009 TO 28 FEBRUARY 2010: HOLIDAY HOME
NAME OF HOLIDAY HOUSE: .......................................................................................................................
NTB REGISTRATION NUMBER:
NAME OF OWNER:
POSTAL ADDRESS/POSADRES
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PHYSICAL ADDRESS/FISIESE ADRES
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TELEPHONE NUMBER/TELEFOON NOMMER:
FAX NUMBER/FAKS NOMMER:
E-MAIL
ADDRESS
WEBSITE ADDRESS
NAME OF BOOKING AGENT:
ATTACHED PLEASE FIND MY CHEQUE/CASH FOR: N$
I HEREBY AGREE TO BE BOUND BY THE ASSOCIATIONS CONSTITUTION AND ALL AMENDMENTS THERETO
SIGNED AT .......................................... ON THE ....... DAY OF ............................... 2009
SIGNATURE/HANDTEKENING:
BANK DETAILS:
BANK WINDHOEK
SWAKOPMUND BRANCH: 481772
ACCOUNT NO: 8000 252 384
Fax to: +264-64-501142